- In a hematology clinic at Nationwide Children’s Hospital, Amy Dunn, MD, can administer an intravenous treatment to one of her pediatric patients with hemophilia, completely fear-free. This care experience is thanks to virtual reality (VR) in healthcare, which can make needle sticks in children less stressful and maybe even – dare we say it – fun.
VR has not only helped enhance the patient experience at Nationwide Children’s Hospital, but has also landed the organization among the American Hospital Association’s 2017 Most Wired rankings.
Nationwide Children’s VR adoption began with one very common issue: kids are often afraid of needles. In the Nationwide Children’s Hospital hemophilia clinic, of which Dunn is the director, this can be a significant barrier to a positive care experience.
Patients with hemophilia commonly receive intravenous infusion of clotting factor as their sole treatment, and it requires patients to be infused with the medication using a needle. Patients need to undergo this treatment starting from their first diagnosis throughout the rest of their lives.
“That is a lot of IV sticks,” Dunn said in an interview with PatientEngagementHIT.com. “If we run into issues with needle phobia, it’s a devastating complication for us.”
That is because when there is a fear of needles, it is palpable for everyone during the care encounter.
“Even with children and their families knowing that this is what they have to do to stay healthy, we see a lot of anxiety or crying, trying to run or hide,” Dunn reported. “We see patients not wanting to come to clinic, who won’t talk about their medicine, or who will hide bleeds from their parents. We see a lot of avoidance behaviors.”
Source: Nationwide Children's Hospital
Parents are not immune to feelings of dread leading up to clinic visits, either. It can be devastating for a parent to know that his child has a phobia of the very treatment necessary to maintain that child’s health. This level of anxiety on parents’ ends further aggravates the negative feelings their children are already feeling, Dunn pointed out.
Nurses also feel the impacts of needle phobia. These clinicians are on the frontlines of nearly all patient encounters, and can get worn down by constantly delivering a terrifying procedure to children.
But when the care team can distract the patient – in this case, by using VR – it allows them to take the care encounter back into their hands and drive a better experience.
“This VR system allows the medical teams to be in charge of what’s going on and help the whole process go better, causing nurse satisfaction,” Dunn said. “They know they’ve controlled the situation and relieved anxiety.”
Dunn enlisted the help of Jeremy Patterson, Lead of User Experience Technology Research & Development, to create a VR platform that will enhance the patient experience. Together, the pair wanted to develop a tool that would ideally assuage the fears of the pediatric patient population.
Patterson had been familiar with VR prior to this project, he said during the interview. VR had been used to direct elements of surgical planning, and with behavioral health specialists to help patients overcome phobias. In the latter case, patients would use VR to ease their way into a fearful setting to eventually overcome it.
“What we actually did was the opposite,” Patterson said. “We weren’t trying to put someone in a situation that they find fearful. That’s the antithesis of what we wanted to do. We did know the power of being able to put someone into a reality where they can ignore what their current reality is.”
Source: Nationwide Children's Hospital.
One can see that new reality on the Nationwide Children’s website. Partnered with VR vendor Voxel Bay, the tool Dunn and Patterson use makes a game out of the clinic visit. This puts the patient in a more relaxing, even fun, environment.
“Patients are in a completely different world,” Patterson explained. “This world is fun and engaging, lets them play games, introduces them to new characters. It takes them out of what is normally a stressful situation and puts them into a fun world.”
This technology doesn’t benefit only the pediatric patients, according to Dunn. The VR incorporates novel features that involve everyone in the room as an active participant in the VR experience. Instead of being a solo experience, the VR becomes a group activity, helping to bring parents and nurses into the child’s world.
Incorporating VR into the patient encounter ended up receiving the seal of approval from both patients and their parents, Dunn reported. Any concerns she had about patients using, understanding, and enjoying the technology quickly melted away.
“The children were able to figure things out very easily,” Dunn recalled. “This generation is very technically savvy. We had been concerned about whether the kids could pick it up or figure out the games, but they could. They said the games were fun and wanted to use them again.”
Dunn and Patterson can’t only credit their success to simply having a good idea – although this certainly was a good idea. Having Patterson working on-site as a Nationwide Children’s employee also had its benefits, the pair said. Patterson and his team understood the importance of HIPAA compliance, for example.
When piloting the VR technology, Patterson was there to make the adjustments necessary for a VR tool used in a very specific setting – pediatric hematology and oncology. Patterson could more easily meet the needs of this unique patient population than an outside contractor may have, the pair said.
Dunn did acknowledge that patients can’t use the VR forever. She needed a contingency plan to start phasing out the technology as patients got older and ideally outgrew their fears.
“We definitely wean patients off because we want patients to eventually do their own infusions, so they have to be able to see,” Dunn explained.
The headset has the capability for patients to look outside of the VR world whenever they would like, helping to drive the transition off of the device.
“We’ve set ourselves up for that because we can transition from immersive to real life leading right up to the procedure, and eventually children can transition completely off of the VR,” Dunn said.
This type of VR – the type that puts patients in a new, more enjoyable experience – is the future of VR in healthcare, Patterson asserted. While there are numerous purposes for VR being floated, including using it for data visualization and surgical planning, using VR to place patients in an enjoyable reality is leading the way, Patterson posited.
“We took it to a place where we were looking at what the patient experience is like,” Patterson said. “Can we create a way to make a better experience, or a fun experience, into a clinic where normally the experience is not fun? We used it as a tool to be able to bring that fun experience, which is something totally different.”
Dunn added that there may be new uses for using VR in the patient experience in the future.
“If designed correctly, VR has great potential to positively affect the patient and family experience,” she concluded. “What we will need to do is design VR experiences tailored for different patient situations and then evaluate if we can improve outcomes and help nurses and staff deliver care in a more pleasant way.”